The Effect of Depression and Anxiety Symptoms on the Results of Combined Dexamethasone/Corticotropin Releasing Hormone Test in Patients with Schizophrenia

Han, Byung Jin; Lee, Sang Ick; Shin, Chul Jin; Son, Jung Woo

Abstract

OBJECTIVES
The aim of this research is to determine the effects of depression and anxiety symptoms of schizophrenic psychopathology on the HPA axis.
METHODS
Twenty patients with schizophrenia were included and divided into the medication non-exposed group(n = 10) and the medication exposed group(n = 10). Evaluated scales were the Positive and Negative Syndrome Scale(PANSS), Scale for the Assessment of Negative Symptoms(SANS), Scale for the Assessment of Positive Symptoms(SAPS), Hamilton Depression Inventory(HAM-D) and Hamilton Anxiety Inventory (HAM-A), and then the combined Dexamethasone/Corticotropin Releasing Hormone(DEX/CRH) test was conducted to determine the basal level, the peak level and the area under the curve(AUC) of cortisol and adrenocorticotropic hormone(ACTH).
RESULTS
When the correlations between each psychopathology and cortisol level or ACTH AUC value were analyzed, HAM-D showed a negative correlation, whereas HAM-A showed a positive correlation. Also, the non-depression group(HAM-D < or = 18) showed higher cortisol and ACTH concentrations than the depression group(HAM-D > 18), and the anxiety group(HAM-A > or = 14) showed significantly higher concentrations than the non-anxiety group(HAM-D < 14)(p < 0.05). Also, as for the comparison between the medication non-exposed group and the medication exposed group, the non-exposed group showed significantly higher cortisol and ACTH concentration than exposed group(p < 0.05).
CONCLUSION
This study suggest that anxiety symptoms rather than depression symptoms are related to the increased activity of the HPA axis of schizophrenics.